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What Are The Risks Of COVID-19 If Your Taking Other Medications?

If you are concerned about your risk of COVID-19 due to your prescription medication, speak with your doctor. The prescribed medications are intended

What Are The Risks Of COVID-19 If Your Taking Other Medications?

If you are concerned about your risk of COVID-19 due to your prescription medication, speak with your doctor. The prescribed medications are intended to improve and not imperil health. Yet since the advent of the novel coronavirus pandemic, even the medical community has been wondering whether such medications may have an adverse impact.

It could work in two ways: Drugs could theoretically raise the risk of being diagnosed with COVID-19, or if you get ill, drugs could lead to a more serious course of the disease. We also looked closely at the drug work in question, which includes heartburn proton pump inhibitors (PPIs), immunosuppressants, and high blood pressure medications.

Here's the scoop on how they're really putting you at risk and you should take action to remain safe. (Spoiler alert: Keep taking your medications unless your doctor has ordered otherwise!)

Medication for Heartburn, and COVID-19

Sure, this news sounds shocking, but medical experts alert people not to panic: a July 2020 report in the American Journal of Gastroenterology, based on an online survey of over 53,000 Americans, indicates that people who used PPI heartburn drugs, such as omeprazole and esomeprazole, had substantially improved chances of a positive COVID-19 check daily.

Researchers have not found a strong correlation between COVID-19 and people taking milder heartburn medications, such as famotidine or cimetidine.

"I am not aware of any medicines which increase the chances of COVID-19 contracting."

PPIs work to neutralize your stomach acid — so why would it increase the risk for coronavirus?

The researchers agreed early on in the pandemic to investigate the relationship between PPIs and COVID-19 when they began to see a large number of digestive symptoms in patients. We discovered that saliva is released by the coronavirus, and can then be swallowed into the stomach.

Under normal conditions, before they reach the GI tract, stomach acid will be able to scrub off pathogens (including coronaviruses) with ease.

But PPI drugs make your gut's pH less acidic, diminishing its ability to kill germs and making it easier for viruses to gain hold. For example, in the Annals of Pharmacotherapy, PPI users experience a higher incidence of intestinal infections such as salmonella, per a July 2018 analysis.

And the novel coronavirus, unlike salmonella, attacks the lungs instead of your stomach.

"The stomach is not an important part of the COVID-19 infection cycle or the recovery from this virus, so it's unclear whether it will have an impact," says Michael Ison, MD, professor of medicine and surgery at the Feinberg School of Medicine in Northwestern. "I am not aware of any medicines which increase the chances of COVID-19 contracting."

Please bear in mind that this was an anonymous self-reported study, so you need to take the findings with a grain of salt.

Important

When you are taking PPIs, you don't need to panic or throw your drugs in the garbage.

Immunodepresseurs and COVID-19

According to the Centers for Disease Control and Prevention ( CDC) people with compromised immune systems may be more likely to get seriously sick from the novel coronavirus.

If you take a drug that stifles your immune system, the body will not be able to fend off infections as effectively.

"Medications that weaken the immune response — such as chemotherapy agents, corticosteroids, and immunosuppressants are given to patients with strong organ transplants — threaten you with a more serious course of illness," says Dr. Ison. (Although steroids are successful in treating advanced stages of COVID-19 infection, they may have a harmful impact if you get sick at first.)

"Patients who contract COVID-19 while taking these drugs are more likely to get hospitalized, end up in ICU and die," says Dr. Ison.

Let's look at how a balanced immune system functions to kill pathogens, to understand why.

"Lymphocytes, which are one form of white blood cells, recognize and destroy infected cells so that the virus is unable to reproduce in them," says Dr. Ison. "White blood cells often contain antibodies that interact with antigens, preventing the virus from infecting new cells, and improving clearance of diseases."

Furthermore, your body can be activated by both lymphocytes and antibodies to churn out chemicals, such as interferons and cytokines, that help your immune system remove illness.

Yet when you take a drug that stifles your immune system, the body can't fend off infections as effectively as possible.

"Some of the drugs used in cancer patients, for example, have an adverse effect either on lymphocytes or on the ability to produce antibodies, and you have fewer cells to help fend off infection," says Dr. Ison. "This can result in a greater viral load than those with a fully functioning immune system."

Bottom Line

Individuals who take immunosuppressants may have an elevated risk for serious COVID-19 outcomes. Such drugs, however, serve an important purpose — speak to your doctor if you have questions, and before discontinuing use.

Medications for blood pressure, and COVID-19

This one you're in with is clear. In March of this year, America's American College of Cardiology, American Heart Association, and Heart Failure Society released a joint statement expressing concern that some blood pressure medications that increase the risk with COVID-19 for poor outcome. This proved later not to be the case.

"People have concentrated on blood pressure medications since the coronavirus infects cells by binding to an enzyme called ACE2, which is responsible for controlling blood pressure," says Dr. Ison.

The medical community has theorized that some blood pressure drugs, called ACE inhibitors and angiotensin receptor blockers, may increase the amount of ACE2 on cell surfaces, thereby raising the risk of infection and disease severity.

Yet a report by the American Society of Nephrology Journal in July 2020 showed a decline in ACE2 receptors and zero lung membrane changes in mice.

"This research supports the idea that there is no increased risk of COVID-19 infection with the use of ACE inhibitors and angiotensin receptor blockers," research author Daniel Batlle, MD, professor of medicine at the Feinberg School of Medicine at Northwestern University, said in a press release in Northwestern Now.

Bottom Line

Use ACE inhibitors may not raise the risk of serious outcomes for people with COVID-19 infections, although there is a need for further studies.

What Should You Do if You’re Worried About Your Medications?

Should not quit taking prescription pharmaceutical drugs until your doc agrees.

"The drug you are taking has an advantage, otherwise you will not be taking it," says Dr. Ison. "In fact, you can do much more harm to yourself by stopping the drug without having a plan with your doctor."

When you have concerns about the safety of your medications, contact your doctor. Many now give access to telemedicine and there's a fair chance you're not going to have to walk in a clinic.

Take extra care if you are on immunosuppressants

First, here's a refresher on what everybody can do to stay safe, the CDC says:

  1. Wash your hands regularly and often, or use a hand sanitizer of at least 60 percent alcohol when there is no soap and water.
  2. Keep a distance of at least six feet from people outside your home.
  3. Wear a mask in public or people who don't stay with you while you are with them.

The CDC has also released improved recommendations on infection prevention for vulnerable groups, particularly those on immunosuppressants, which go beyond the standard protocol:

  1. Restricted contacts with non-household people.
  2. When you go out to the city, stop or question people who don't wear face coverings.
  3. Don't hang out with people who have been exposed in the past 14 days to someone with COVID-19, or who have signs of the virus.
  4. Ideally, if you visit friends or relatives, live outdoors; if that is not possible, stick to a well ventilated indoor space with open windows and doors.

"Minimize big crowds and, if possible, stop going to grocery stores," adds Dr. Ison. "And don't go to restaurants indoors if there's a big COVID-19 case in your area."

As long as you are vigilant in adhering to these instructions and following the advice of your doctor, the risk of being infected should be minimized.

"Information on COVID-19 is constantly changing which is as frustrating for patients as it is for doctors," says Dr. Ison. "But when you consider that nobody knew anything about this disease seven months ago, it's actually miraculous that we understand just as much as we do today."

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